This study assessed public support for new tobacco control measures in Poland, including a smoking ban on private balconies, regular tobacco tax increases, and a total ban on tobacco sales. A nationwide cross-sectional survey was conducted in 2024 using a computer-assisted web interview (CAWI). The 1080 adults (aged 18-82 years) were interviewed, of which 53% were females. A self-prepared questionnaire included questions on support for various tobacco control measures. The primary outcomes were levels of support for each proposed measure. Attitudes were measured using a 5-point Likert scale, and independent variables included sociodemographic factors and smoking status. The smoking ban on private balconies was supported by 44.1% of respondents, with higher support among older adults, non-smokers, and those with higher education. Support for annual tobacco tax increases was 47.1%, particularly among younger and middle-aged adults, the educated, and non-smokers. A total of 41.8% of respondents declared support for the total ban on tobacco sales. Higher education, non-smoking status, and voluntary smoke-free home rules were significantly associated (p<0.05) with higher support for all three tobacco control measures. There was no significant impact (p>0.05) of the gender, financial status, household size, and location of the place of residence on public support of analyzed tobacco control measures. This study revealed that less than half of adults in Poland declare support for extensive tobacco regulations such as a smoking ban on private balconies, taxation increases, and a ban on tobacco sales. Educational level and smoking status are significantly associated with public attitudes toward tobacco control measures.

Prior research has found that premium cigar marketing highlights favorable themes (e.g. glamour), and reinforces the idea that premium cigars are part of a successful, luxurious lifestyle. Yet, all but one of these studies are more than 20 years old and more recent data on premium cigar marketing is needed. This study adds to the literature by a providing a comprehensive, topical examination of all content promoted in all 2023 issues of Cigar Aficionado, a prominent cigar lifestyle magazine. Codes were identified through a literature review and scan of issues of Cigar Aficionado from 2022. Codes included but were not limited to cigars, alcohol, travel, cigar festivals, celebrities, and cigar storage products. All coding was done in excel and then exported to Stata/MP 17 for analysis. Analysis of articles and ads were done separately. Among ads, the most common topics were cigars (64.5%), alcohol (31.1%), and cigar stores/retailers (14.5%). For articles, the most common topics were cigars (49.6%), cigar reviews/spotlights (23.3%), and celebrities (19.5%). Among ads for cigar products where country of origin could be identified (44.6%), most cigars featured were from Nicaragua (65.0%) and the Dominican Republic (25.2%), followed by Honduras (7.3%), Costa Rica (1.6%), and Cuba (0.8%). Overall, marketing in the 2023 Cigar Aficionado issues is similar to marketing strategies from the 1990s. Future research should explore health claims and other marketing strategies used in Cigar Aficionado, and other lifestyle magazines, as well as observe marketing trends over time.

The COVID-19 pandemic caused major stress, as well as changes to home and work environments, with the potential to alter smoking-related behaviors. This study examined determinants of smoking-related behaviors among patients of federally qualified health centers (FQHCs) in Georgia. We analyzed survey data from 353 patients (mean age=50 years, 62.9% women, 54.4% Black/African American, 27.8% <high school education, 56.5% ≤$25000 annual income) enrolled in a smoking cessation trial, from 3 FQHCs in rural Georgia (November 2020 to December 2022). Multivariable multinomial regression examined home smoking environments (i.e. household members who smoke, household smoking rules) and changes in stress in relation to: 1) smoking increases/decreases in general and in the home, and 2) quit attempts since pre-pandemic. Most study participants (85.6%) smoked daily, and 41.6% had smoke-free homes. Compared to pre-pandemic, 36.3% reported increased stress, 28.8% increased smoking, 18.8% increased in-home smoking, and 55.4% quit attempts. Regression models showed more household members who smoke (AOR=1.56; 95% CI: 1.02-2.39) and greater stress (AOR=5.52; 95% CI: 2.74-11.12) were associated with increased smoking (vs no change) since the pandemic began. Non-daily (vs daily) smoking (OR=4.79; 95% CI: 1.71-13.46) was associated with decreased smoking (vs no change). Allowing smoking in the home and greater stress were associated with both increased and decreased in-home smoking (vs no change). We found no associations with quit attempts. Home environments, specifically home smoking restrictions, as well as stress, may be important intervention targets during societal stressors.

Lost Mary is a popular e-cigarette brand among youth in the United States. This study aimed to analyze Lost Mary's branded social media activity and assess whether marketing efforts may have contributed to its youth appeal. We conducted a content analysis of 53 Lost Mary posts published on social media platforms from 2022 to 2023. More than a third of the posts included flavor descriptors, including fruit or ice, both popular flavors among youth. More than two-thirds of the posts used vibrant colors, and any human models included appeared to be young adults. Findings suggest that Lost Mary may target youth on social media platforms through the use of youth-appealing advertisement strategies (e.g. flavors). These findings highlight the need for increased monitoring of e-cigarette brand marketing on social media.

In 2023, 6-methyl nicotine (6MN), a synthetic nicotine analog, was introduced in US-marketed electronic cigarette products advertised as exempt from regulation. It is unknown whether the use of 6MN has spread to other product categories. Industry reports, patent and trademark databases were searched for 6-methyl nicotine products. Identified trademarks 'Metatine', 'Nixotine', 'Imotine' were used to search for US-marketed products. Ingredient information was compared to US market-leading products, and safety warnings and regulatory statements were assessed in context with US state and federal regulations. Two US-based oral pouch brands, 'MG' and 'Hippotine' pouches, were identified in August 2024, advertised to contain 'Imotine'-trademarked 6MN. MG Pouches are marketed in four flavors, and 'Hippotine'-branded pouches are marketed in two flavors, likely representing banned flavor characterization in US state jurisdictions such as California. 6MN contents range 8-25 mg. Otherwise, the ingredient lists were almost identical across both product lines. Products list extensive addiction and health warnings, including warnings not to operate vehicles. Vendors state that these are not tobacco products, which implies that federal and state tobacco regulations do not apply. The spread of nicotine analogs to additional product categories, such as oral pouches, is concerning, especially given the high declared 6MN contents exceeding nicotine in popular US-marketed oral nicotine pouch products. Legislators and regulators need to provide certainty about the regulatory status of nicotine analogs to prevent further erosion of tobacco flavor bans and other regulations.

Studies have found that parental smoking is the primary source of secondhand smoke (SHS) exposure among children, leading to respiratory illnesses, especially in non-smokers like children and women. Promoting a smoke-free home (SFH) is essential, especially among rural populations, and barriers or challenges to creating a SFH need to be better understood. This study aimed to determine the knowledge levels on SHS and to identify the beliefs, perceptions, barriers and facilitators of SFH practices among the rural population in Kuala Kubu Bharu, Selangor, Malaysia. This study employed a mixed-methods design, conducted in two rural settlement areas in 2022. Data were collected through surveys on SHS and SFH knowledge and face-to-face interviews using a topic guide. The quantitative data were analyzed using SPSS software while the qualitative data were analyzed using the thematic approach via NVivo 12. Sixty participants completed the survey. Most of the respondents had a good (38%) or moderate (48%) knowledge level of SHS. No association was found between sociodemographic factors and knowledge level. Seven of the nine interviewees knew specific SHS-related health risks. Most participants believed that implementing SFH requires quitting or reducing smoking. Barriers to establishing a SFH included personal convenience, habits, attitudes, and social influence. Family encouragement, practicability, government, and quitting smoking were the facilitators for SFH. These rural communities had moderate knowledge level of SHS and SFH. Men's knowledge, beliefs and perceptions like associating SFH with quitting smoking may prevent SFH adoption. It is critical for the government and stakeholders to disseminate information and develop socially and culturally acceptable health promotion programs, incorporating the considerations from this study to increase the chances of SFH implementation in rural areas.

Adolescents are vulnerable to tobacco advertising, promotion, and sponsorships (TAPS). The presence of TAPS, specifically outdoor cigarette advertisements (OCA) and cigarette retailers (CR), impacts adolescent smoking behavior. This study examined the presence of OCA and CR near Indonesian schools and students' report of their TAPs exposure. We conducted a cross-sectional study in the three diverse districts (Serang, Banyuwangi, and East Lombok) and a city district (Padang), Indonesia on September 2022-April 2023. In each district, we selected the three subdistricts with the most schools and the highest population density. Enumerators mapped all outdoor OCA and CR using Global Positioning System (GPS) devices. In selected schools within the study areas, we surveyed 6715 students about their TAPs exposure using face-to-face interviews. Students were selected using multistage cluster sampling. Data were analyzed descriptively using STATA 14.2. Of the 21460 retailers identified in the subdistricts, 30.4% were CR. The proportion of CR varied by district, between 24.8% and 40.7%. East Lombok had the highest percentage. Additionally, Banyuwangi had the highest density of CR. There were 13660 OCA points (district range 1918-6472). Around schools, banners were the most common OCA form (62.1%). Posters were second (32.8%). The retailers who sold the most cigarettes in the four districts were in kiosks. The density of CR and OCA per km2 increased as the distance from schools decreased. Students' self-reported exposure to tobacco products was higher from OCA and CR than from the internet, television, and magazines/newspapers. OCA and CR are ubiquitous around schools. The Indonesian government should assess OCA and CR regulations and limit OCA and CR close to schools.

Adolescents are especially vulnerable to the harmful effects of tobacco use. This study examined changes in tobacco use in schools, the provision of anti-tobacco education, and cessation efforts over time, and the importance of cessation support and education for cessation efforts among youth aged 13-15 years. We performed secondary analyses of cross-sectional data from the latest two rounds of the Global Youth and Tobacco Survey (GYTS). Forty-five countries met the inclusion criteria for examining changes in quit attempts; 42 for receipt of cessation support; 28 for anti-tobacco education; 27 for tobacco use in schools, and 45 for the combined analysis of the association between cessation support and anti-tobacco education with quit attempts. To assess differences between the rounds, crude and adjusted prevalence estimates were compared as average adjusted predictions from univariate and multivariate logistic regressions. The association between quit attempts and other characteristics was examined using mixed effects binary logistic regression with a random intercept for the country. Percentages of youth who attempted to quit smoking (11/45), received cessation support (12/42), or saw others smoking on school premises (5/27) did not change in the majority of countries between survey rounds after adjusting for age and sex. Over half of the countries (15/27) reported significant changes in provision of anti-tobacco education between survey rounds, after adjustment. In 45 countries, adolescents who received help for quitting smoking (AOR=3.23; 95% CI: 3.02-3.45) or anti-tobacco education (AOR=1.13; 95% CI: 1.06-1.21) were more likely to attempt cessation than those without help or education (p<0.001). Despite the importance of cessation support and anti-tobacco education in promoting quit attempts among adolescents, many countries lack sufficient cessation initiatives for youth. Monitoring these indicators is necessary for guiding the development of public health interventions to reduce tobacco and nicotine product use among youths.